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Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size
Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the in...
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| Published in: | The International Journal of Cardiovascular Imaging 2014-12, Vol.30 (8), p.1509-1518 |
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| creator | Trifunovic, Danijela Sobic-Saranovic, Dragana Beleslin, Branko Stankovic, Sanja Marinkovic, Jelena Orlic, Dejan Vujisic-Tesic, Bosiljka Petrovic, Milan Nedeljkovic, Ivana Banovic, Marko Djukanovic, Nina Petrovic, Olga Petrovic, Marija Stepanovic, Jelena Djordjevic-Dikic, Ana Tesic, Milorad Ostojic, Miodrag |
| description | Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = −0.686,
p
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| doi_str_mv | 10.1007/s10554-014-0497-6 |
| format | article |
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p
< 0.01), DDT (r = −0.727,
p
< 0.01), and DDT adeno (r = −0.780,
p
< 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion.</description><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1573-0743</identifier><identifier>EISSN: 1875-8312</identifier><identifier>DOI: 10.1007/s10554-014-0497-6</identifier><identifier>PMID: 25108390</identifier><identifier>CODEN: IJCIBI</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adenosine ; Aged ; Biomarkers - blood ; Blood Flow Velocity ; Cardiac Imaging ; Cardiology ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - physiopathology ; Creatine Kinase, MB Form - blood ; Echocardiography, Doppler ; Feasibility Studies ; Female ; Fractional Flow Reserve, Myocardial ; Humans ; Imaging ; Male ; Medicine ; Medicine & Public Health ; Microcirculation ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - blood ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardial Perfusion Imaging - methods ; Original Paper ; Percutaneous Coronary Intervention ; Predictive Value of Tests ; Prospective Studies ; Radiology ; Serbia ; Time Factors ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome ; Vasodilator Agents</subject><ispartof>The International Journal of Cardiovascular Imaging, 2014-12, Vol.30 (8), p.1509-1518</ispartof><rights>Springer Science+Business Media Dordrecht 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-f6ac10c93e4217b84bd94374652061b504502344e50dc393e416e3d4b59558203</citedby><cites>FETCH-LOGICAL-c442t-f6ac10c93e4217b84bd94374652061b504502344e50dc393e416e3d4b59558203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25108390$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trifunovic, Danijela</creatorcontrib><creatorcontrib>Sobic-Saranovic, Dragana</creatorcontrib><creatorcontrib>Beleslin, Branko</creatorcontrib><creatorcontrib>Stankovic, Sanja</creatorcontrib><creatorcontrib>Marinkovic, Jelena</creatorcontrib><creatorcontrib>Orlic, Dejan</creatorcontrib><creatorcontrib>Vujisic-Tesic, Bosiljka</creatorcontrib><creatorcontrib>Petrovic, Milan</creatorcontrib><creatorcontrib>Nedeljkovic, Ivana</creatorcontrib><creatorcontrib>Banovic, Marko</creatorcontrib><creatorcontrib>Djukanovic, Nina</creatorcontrib><creatorcontrib>Petrovic, Olga</creatorcontrib><creatorcontrib>Petrovic, Marija</creatorcontrib><creatorcontrib>Stepanovic, Jelena</creatorcontrib><creatorcontrib>Djordjevic-Dikic, Ana</creatorcontrib><creatorcontrib>Tesic, Milorad</creatorcontrib><creatorcontrib>Ostojic, Miodrag</creatorcontrib><title>Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size</title><title>The International Journal of Cardiovascular Imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = −0.686,
p
< 0.01), DDT (r = −0.727,
p
< 0.01), and DDT adeno (r = −0.780,
p
< 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion.</description><subject>Adenosine</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Blood Flow Velocity</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - physiopathology</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Echocardiography, Doppler</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microcirculation</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myocardial Infarction - blood</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardial Perfusion Imaging - methods</subject><subject>Original Paper</subject><subject>Percutaneous Coronary Intervention</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radiology</subject><subject>Serbia</subject><subject>Time Factors</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Treatment Outcome</subject><subject>Vasodilator Agents</subject><issn>1569-5794</issn><issn>1573-0743</issn><issn>1875-8312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp1kd1qFTEUhYNYbK0-gDcS8KY3Y3d-58ylnNYfKHij1yGT2WNT5iRjklHqY_jEZpjTIoKQkMD-9lo7WYS8YvCWAbSXmYFSsgFWt-zaRj8hZ0y1ooFWiqfrXXeNajt5Sp7nfAcAHLh4Rk65YrATHZyR3_uYYrDpno5T_EnjSMstUh9Gm1yhNhWsJZsz1jXQ_p6WZEMutzFZ5x29ivM8YaJ2rCCdkz-sUjMmtxQbMC6ZugcDHyrzA0PxMVQUB-9KpqMPdno0zP4XviAno50yvjye5-Tr--sv-4_NzecPn_bvbhonJS_NqK1j4DqBkrO238l-6KRopVYcNOsVSFUfKyUqGJxYMaZRDLJXnVI7DuKcXGy6c4rfF8zFHHx2OE3b4IZproSsnaqib_5B7-KS6uAbBTul1UqxjXIp5pxwNMcPMQzMGpjZAjM1MLMGZnTteX1UXvoDDo8dDwlVgG9ArqXwDdNf1v9V_QNh0aJw</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Trifunovic, Danijela</creator><creator>Sobic-Saranovic, Dragana</creator><creator>Beleslin, Branko</creator><creator>Stankovic, Sanja</creator><creator>Marinkovic, Jelena</creator><creator>Orlic, Dejan</creator><creator>Vujisic-Tesic, Bosiljka</creator><creator>Petrovic, Milan</creator><creator>Nedeljkovic, Ivana</creator><creator>Banovic, Marko</creator><creator>Djukanovic, Nina</creator><creator>Petrovic, Olga</creator><creator>Petrovic, Marija</creator><creator>Stepanovic, Jelena</creator><creator>Djordjevic-Dikic, Ana</creator><creator>Tesic, Milorad</creator><creator>Ostojic, Miodrag</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size</title><author>Trifunovic, Danijela ; Sobic-Saranovic, Dragana ; Beleslin, Branko ; Stankovic, Sanja ; Marinkovic, Jelena ; Orlic, Dejan ; Vujisic-Tesic, Bosiljka ; Petrovic, Milan ; Nedeljkovic, Ivana ; Banovic, Marko ; Djukanovic, Nina ; Petrovic, Olga ; Petrovic, Marija ; Stepanovic, Jelena ; Djordjevic-Dikic, Ana ; Tesic, Milorad ; Ostojic, Miodrag</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-f6ac10c93e4217b84bd94374652061b504502344e50dc393e416e3d4b59558203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adenosine</topic><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Blood Flow Velocity</topic><topic>Cardiac Imaging</topic><topic>Cardiology</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Coronary Vessels - physiopathology</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Echocardiography, Doppler</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Fractional Flow Reserve, Myocardial</topic><topic>Humans</topic><topic>Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microcirculation</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myocardial Infarction - blood</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardial Perfusion Imaging - methods</topic><topic>Original Paper</topic><topic>Percutaneous Coronary Intervention</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radiology</topic><topic>Serbia</topic><topic>Time Factors</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Treatment Outcome</topic><topic>Vasodilator Agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trifunovic, Danijela</creatorcontrib><creatorcontrib>Sobic-Saranovic, Dragana</creatorcontrib><creatorcontrib>Beleslin, Branko</creatorcontrib><creatorcontrib>Stankovic, Sanja</creatorcontrib><creatorcontrib>Marinkovic, Jelena</creatorcontrib><creatorcontrib>Orlic, Dejan</creatorcontrib><creatorcontrib>Vujisic-Tesic, Bosiljka</creatorcontrib><creatorcontrib>Petrovic, Milan</creatorcontrib><creatorcontrib>Nedeljkovic, Ivana</creatorcontrib><creatorcontrib>Banovic, Marko</creatorcontrib><creatorcontrib>Djukanovic, Nina</creatorcontrib><creatorcontrib>Petrovic, Olga</creatorcontrib><creatorcontrib>Petrovic, Marija</creatorcontrib><creatorcontrib>Stepanovic, Jelena</creatorcontrib><creatorcontrib>Djordjevic-Dikic, Ana</creatorcontrib><creatorcontrib>Tesic, Milorad</creatorcontrib><creatorcontrib>Ostojic, Miodrag</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest - 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Academic</collection><jtitle>The International Journal of Cardiovascular Imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trifunovic, Danijela</au><au>Sobic-Saranovic, Dragana</au><au>Beleslin, Branko</au><au>Stankovic, Sanja</au><au>Marinkovic, Jelena</au><au>Orlic, Dejan</au><au>Vujisic-Tesic, Bosiljka</au><au>Petrovic, Milan</au><au>Nedeljkovic, Ivana</au><au>Banovic, Marko</au><au>Djukanovic, Nina</au><au>Petrovic, Olga</au><au>Petrovic, Marija</au><au>Stepanovic, Jelena</au><au>Djordjevic-Dikic, Ana</au><au>Tesic, Milorad</au><au>Ostojic, Miodrag</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size</atitle><jtitle>The International Journal of Cardiovascular Imaging</jtitle><stitle>Int J Cardiovasc Imaging</stitle><addtitle>Int J Cardiovasc Imaging</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>30</volume><issue>8</issue><spage>1509</spage><epage>1518</epage><pages>1509-1518</pages><issn>1569-5794</issn><eissn>1573-0743</eissn><eissn>1875-8312</eissn><coden>IJCIBI</coden><abstract>Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = −0.686,
p
< 0.01), DDT (r = −0.727,
p
< 0.01), and DDT adeno (r = −0.780,
p
< 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>25108390</pmid><doi>10.1007/s10554-014-0497-6</doi><tpages>10</tpages></addata></record> |
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| subjects | Adenosine Aged Biomarkers - blood Blood Flow Velocity Cardiac Imaging Cardiology Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Creatine Kinase, MB Form - blood Echocardiography, Doppler Feasibility Studies Female Fractional Flow Reserve, Myocardial Humans Imaging Male Medicine Medicine & Public Health Microcirculation Middle Aged Multivariate Analysis Myocardial Infarction - blood Myocardial Infarction - diagnostic imaging Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocardial Perfusion Imaging - methods Original Paper Percutaneous Coronary Intervention Predictive Value of Tests Prospective Studies Radiology Serbia Time Factors Tomography, Emission-Computed, Single-Photon Treatment Outcome Vasodilator Agents |
| title | Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size |
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